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Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone: (830) 237-2886 Fax: (866) 855-8301 Email: [email protected] Website: www.ASDpuzzle.com BOOK: EATING FOR AUTISM

Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

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Page 1: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them

Elizabeth Strickland, MS, RD, LDPO Box 3297 Glen Rose, TX 76043

Telephone: (830) 237-2886 Fax: (866) 855-8301Email: [email protected] Website: www.ASDpuzzle.comBOOK: EATING FOR AUTISM

Page 2: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them

AUTISMShould I put my child on the Gluten Free Casein Free Diet?

What nutritional supplements should I give my child?

My child is a picky eater how can I expand his diet?

Page 3: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

What is Autism?Autism Spectrum Disorder299.00 Autistic Disorder299.80 Asperger’s Disorder299.80 Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS)

Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)American Psychiatric Association

Page 4: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Autism Spectrum Disorder

ASD Puzzling childhood

disorder 1 in 88 children 1 in 54 boys Affects communication,

social interaction and behavior

Spectrum disorder

Page 5: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Should I put my child on the GFCF Diet?

Elimination Diets common in the autism community:

Gluten Free Casein Free Diet (GFCF)

Others: Specific Carbohydrate Diet (SCD) Gut & Psychology Syndrome Diet (GAPS) Rotation Antifungal Feingold Low Oxalate

Page 6: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Gluten Free Casein Free Diet

The GFCF Diet is the single most common Elimination/Challenge diet recommended for children with autism.

There is very little evidence-based

scientific research that supports or refutes claims of the GFCF Diet.

Page 7: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Gluten Free Casein Free Diet

Ongoing Research:

“Diet and Behavior in Young Children with Autism.”

Sponsor: National Institute of Mental Health

Clinical Trials Identifier: NCT00090428

“A Study to Assess the Role of a GFCF Diet in the

Dietary Management of Autism Associated

Gastrointestinal Disorders.”

Sponsor: Massachusetts General Hospital

Clinical Trials Identifier: NCT01116388

Website: www.clinicaltrials.gov

Page 8: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Gluten Free Casein Free Diet

Positive results reported by parents:Improves gastrointestinal symptomsDecreases hyperactivityIncreases focusReduces behavioral problemsImproves speech & communication skillsImproves sleep

Page 9: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Gluten Free Casein Free Diet

Gluten is the protein found in:

WheatBarleyRye

Common food products to avoid: Bran Couscous Cream of wheat Farina Kamut Malt Matzo/matzoh meal Oats and oatmeal Pasta Seitan Semolina Splet Tabbouleh Tritical Udon Wheat germ, flour, and starch

Page 10: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Gluten Free Casein Free Diet

Food additives may contain gluten: Emulsifiers Fillers Flavoring Hydrolyzed vegetable protein Texturized vegetable protein Modified food starch Seasonings Stabilizers Vegetable protein

Nonfood sources of gluten: Over the counter medications Vitamin mineral supplements Lipstick, lip gloss, & lip balms Play-Doh Glue

Page 11: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Gluten Free Casein Free Diet

Casein is the protein found in:

Cow’s milkCow’s milk

products

Common foods to avoid: Cow’s milk Butter Caseinates Cheese and cottage cheese Cream Curds Custard and pudding Ghee Goat’s milk Half & Half Ice Cream, Ice Milk, & Sherbet Lactoglobulin, Lactalbumin, Lactoferrin Milk chocolate Nougat Rennet Sour cream Whey Yogurt

Page 12: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Gluten Free Casein Free Diet

Food products and additives that may contain casein: Brown sugar flavoring Canned tuna Caramel flavoring Chocolate Commercially prepared mixes Lactic acid starter culture Margarine Packaged dinners Processed meats (hot dogs, luncheon, and sausage) Natural flavoring Nondairy creamer Salad dressings Sauces and soups Simplesse Vegetarian nondairy cheese substitutes Whipped topping

Page 13: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Gluten Free Casein Free Diet

Should I put my child on the GFCF Diet?

“Clinical observation and anecdotal reporting warrants a case-by-case considerationfor a GFCF Diet trial response.”

Elizabeth Strickland, MS, RD, LD

Page 14: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

My Child is a Picky Eater How Can I Expand His Diet?

Page 15: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Picky Eater vs. Problem Feeder

Mealtime myths:“He’ll eat when he gets hungry enough. Kidswon’t starve themselves.”

“Don’t worry, he’ll outgrow his picky eatingstage.”

This is NOT true for most autistic childrenwho have a feeding problem as opposed to atypical developing child who is a picky eater.

Page 16: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Picky Eater vs. Problem Feeder

Picky Eater Decreased variety of

food (< 30 foods). Foods lost due to burn-

out regained after 2 wks. Able to tolerate new

foods on plate, touch, or taste.

Eats at least 1 food from most food textures.

Adds new foods to repertoire in 15-25 steps.

Problem Feeder Restricted range of

foods (< 20 foods). Foods lost due to burn-

out, foods not regained. “Falls apart” when

presented new foods. Refuses entire

categories of textures. Adds new foods in > 25

steps.

Kay Toomey, Ph.D.

Page 17: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Feeding Problem“The prevalence of problem eating

behaviors in children with autism has been

estimated to range between 46% and

89%.”

Feeding problems in children with autism spectrum disorders: a review.

Focus Autism Other Dev Disabil.

2006;21(3):153-166.

Page 18: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Feeding ProblemCommon Mealtime Behaviors in

Children with ASD:1. Selective food refusal2. Food neophobia (fear of trying unfamiliar foods)

3. Nonfunctional mealtime rituals

4. Tantrums

Page 19: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Feeding ProblemContributing Factors:1. Medical2. Psychological3. Nutritional4. Oral-Motor Dysfunction5. Sensory Processing Disorder6. Environmental7. Child 8. Parent9. Therapist10. Behavioral

Page 20: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Feeding Problem

Do NOT allow child to “graze” 3 meals + 3 snacks per day Limit juice, milk, beverages to appropriate amounts Avoid distractions during mealtime Practice “social modeling” Offer manageable foods Positive reinforcement Use appropriate mealtime language

Basic Mealtime Strategies

Page 21: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Feeding Problem

Prevent food repetition and burn-out Change one property of the same food each time

offered Expose child to a non-preferred food on a daily basis Do NOT bribe, beg, or force child to “take a bite” Limit mealtime to less than 30 minutes Keep meal & snack times a pleasant atmosphere

Basic Mealtime Strategies

Page 22: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Feeding Problem

Feeding Team Physician Registered Dietitian Behavioral Specialist Occupational

Therapist Speech Language

Pathologist

1. Build a multi-disciplinary Feeding Team

2. Individual team members complete an assessment

3. List of the contributing factors

4. Develop a Feeding Intervention Plan

5. Implement the feeding therapy sessions

Feeding Therapy

Page 23: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Feeding TherapyWhat feeding methods are NOT helpful?

1. Mere exposure to food

2. Food Deprivation

Research supports that mere exposure to food will

increase food preference among typically developing

children; however, no studies support this technique is

effective for treating children with feeding problems.

Page 24: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Feeding TherapyWhat feeding methods are helpful?A combination of feeding methods varying

for each child based on their individual

feeding problems.Building on preferred foodsBehavioralSensory

Page 25: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

SOS Approach to Eating

Steps to eating:1. Tolerate2. Interact3. Smell4. Touch5. Taste6. EatingSOS Approach to EatingKay Toomey, Ph.D.Pediatric Psychologist

Page 26: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Feeding Problem Eating is one of the most important and

complex skills acquired in early childhood. Children with ASD typically have problems

with feeding. Feeding problems may lead to malnutrition

negatively impacting brain and body function. A multi-disciplinary approach to assessing and

treating the feeding problem is critical. The feeding treatment methods should be

individualized for each child.

Page 27: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

What nutritional supplements should I give my child?

“There are numerous vitamins, minerals,antioxidants, amino acids, nutraceuticals andherbs believed to benefit children with ASD. These supplements are accepted and commonlyused as advanced nutritional interventions in theautism community; however, the medical community may not support their use.”

Elizabeth Strickland, MS, RD, LD

Page 28: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Nutritional Supplements

Lost Causes No More

Alternative Medicine

September 2004 Issue 70

Melanie Haiken

Photography by Arthur Cohen

This situation is NOT appropriate!!!

Page 29: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Vitamin Mineral Supplement

“Most U.S. children do not receive adequatenutrition through their diet and children with ASDhave additional nutritional concerns. Adding adaily multi vitamin and mineral supplement to theautistic child’s treatment plan is warranted.”

Elizabeth Strickland, MS, RD, LD

Page 30: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Vitamin Mineral Supplement

Children with ASD are at increased nutritional risk:

Sensory problemsConsume a limited variety of foodsMealtime behavior problemsElimination diets that limit certain foodsChronic gastrointestinal disorders

Page 31: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Vitamin Mineral Supplement

Subclinical Nutrition DeficiencyA deficiency of a particular vitamin or mineral that is not severe enough to produce a classic deficiency symptom but rather has more global, subtle effects that result in loss of optimal health and impairment of body processes.

Page 32: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Vitamin Mineral Supplement

Nutrient Deficiency Stages1st Preliminary → Depletion of tissue stores

2nd Biochemical → Reduced enzyme activity

3rd Physiologic/Behavior → Subclinical deficiency symptoms

4th Clinical → Symptoms worsen

5th Anatomical → Specific syndromesThe Essential Guide to Vitamins and Minerals

Elizabeth Somer, MA, RD

Page 33: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Vitamin Mineral Supplement

Subclinical nutrition deficiency symptoms:IrritabilityMood and behavior changesPoor concentrationDepressionAnxietySleep disturbancesLoss of appetite

Page 34: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Vitamin Mineral Supplement

Selection of a V/M supplement:Buy from a reputable company

Examples: Kirkman®

www.kirkmangroup.com

Village Green Apothecarywww.myvillagegreen.com

Page 35: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Vitamin Mineral Supplement

Selection of a V/M supplement:Quality Control Procedures

US Pharmacopeia (USP) Consumer Lab NSF International

Page 36: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Vitamin Mineral Supplement

Selection of a V/M supplement:Read the label

Avoid: Artificial colors and flavors Potential allergens

(wheat, milk, soy, egg, corn) Herbs

Page 37: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Vitamin Mineral Supplement

Selection of a V/M supplement:Full spectrum vitamins & minerals

Fat soluble vitamins (A, D, E, K)

Vitamin B complex (B1, B2, B3, B5, B6, B12, folic acid, biotin)

Vitamin C Minerals (calcium, magnesium, zinc, selenium, manganese,

chromium, molybdenum)

100 – 300% RDA

Page 38: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Vitamin Mineral Supplement

Approaches to get child to take supplement:

1. Incorporate into child’s Behavior Therapy Program

2. Oralflo pill swallowing cup

3. Pill Swallow Program

4. Negotiation

5. Mix supplement into food or beverageBook: “Eating for Autism”, Chapter 3

Elizabeth Strickland, MS, RD, LD

Page 39: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Vitamin Mineral Supplement

Mix in: Beverages Juice box Fruit smoothie Fruit sorbet Rice dream Yogurt, pudding, custard Peanut butter Fruit preserves Honey Ketchup Cooked foods (after cooking) Popsicles (homemade) Coromega®

Page 40: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Omega-3 Fatty Acids Supplement

“Most U.S. children do not consume anadequate amount of Omega-3 fatty acids intheir diet and Omega-3 fatty acids are essentialfor brain function and vision processing. Addinga daily Omega-3 fatty acid (EPA + DHA)supplement to the autistic child’s treatment planis warranted.”

Elizabeth Strickland, MS, RD, LD

Page 41: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Omega-3 Fatty AcidsDeficiency of Omega-3 fatty acids are linked to:

AutismADHDDyslexiaDyspraxiaDepressionAnxiety

Page 42: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Omega-3 Fatty Acids Neurodevelopmental Disorders: Numerous studies indicate that Omega-3 fatty acids

are deficient in ADHD, dyslexia, and dyspraxia. These neurodevelopmental conditions have a degree

of overlap with autism. Abnormalities in fatty acid metabolism may account for

many features common in these conditions.

Fatty Acid Metabolism in Neurodevelopmental Disorder: A New Perspectiveon Associations Between Attention-Deficit/Hyperactivity Disorder, Dyslexia,

Dyspraxia and the Autistic SpectrumProstaglandins Leukot Essent Fatty Acids 2000;63:1-9

Richardson AJ, et al

Page 43: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Omega-3 Fatty Acids Autism Spectrum Disorder: Studies to assess essential fatty acids for their

role in autism report essential fatty acid deficiency in children with autism.

“Reported DHA 23% reduced, total Omega-3 20%reduced, and Omega-6 unchanged in plasma.”

Plasma Fatty Acid levels in Autistic ChildrenProstaglandins Leukot Essent Fatty Acids 2001:65:1-7

Vancassel S, et al

Page 44: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Omega-3 Fatty Acids“Supplementing children’s diets with Omega-3 fatty acids improves poor learning and behavioral problems.”

Journal of the Developmental and Behavioral PediatricsApril 2007

“Supplementing with Omega-3 fatty acids decreased hyperactivity in children with autismspectrum disorders.” Biological Psychiatry 2007

Page 45: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Omega-3 Fatty AcidsMany research studies indicate that supplementing

with Omega-3 fatty acids reduces:

HyperactivityInattentionImpulsivityAnxietyCognitive problems

Page 46: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Omega-3 Fatty Acids

Functions of Omega-3 Fatty Acids:Brain development of the fetus, infant

and young childMaintenance of normal brain function

throughout lifeVital for brain cell signalingProminent structural fatty acid in the gray

matter of the brain & retinol tissue

Page 47: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Omega-3 Fatty AcidsOmega 6

↓

Linoleic Acid↓

Gamma-Linoleic Acid(GLA)

↓Arachidonic Acid (ARA)

↓Prostaglandin (PG1 & 2)

Omega 3↓

Alpha Linolenic Acid (ALA) ↓ delta-6 desaturase

Eicosapentaenoic Acid (EPA)↓

Docosahexaenoic (DHA)↓

Prostaglandin (PG1)

Page 48: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Omega-3 Fatty AcidsAdequate intake of Omega-3 Fatty Acids:

Age EPA + DHA (combined)

1 – 3 years old 70 mg/day

4 – 8 years old 90 mg/day

9 – 13 years 120 mg/dayFood and Nutrition Board

Institute of Medicine, National Academies

Page 49: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Omega-3 Fatty AcidsAdequate intake of Omega-3 Fatty Acids:

Age EPA + DHA (combined)

1 – 3 years old 390 mg/day

4 – 6 years old 540 mg/day

7 years & older 650 mg/day

National Institutes of Health (NIH)

Page 50: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Omega-3 Fatty AcidsSource EPA + DHA (mg/oz.)Salmon, Atlantic, farmed 608Herring, Pacific 602Herring, Atlantic 571Salmon, Atlantic, wild 521Tuna, fresh (blue fin) 426Mackerel, Atlantic 341Trout, mixed species 265Flounder 142Halibut 132

USDA Nutrient Data Laboratory

Page 51: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Omega-3 Fatty AcidsFDA & EPA recommendations for women who are or maybecome pregnant and nursing mothers: Do NOT eat shark, swordfish, king mackerel, and tilefish. Limit canned albacore “white” tuna to 6 ounces per week. Limit tuna steak to 6 ounces per week. Limit other fish and shellfish to 12 ounces per week. Check local advisories on safety of fish caught in your local

waters. *If no advisory, limit to 6 ounces and

do not eat any other fish that week.

Page 52: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Omega-3 Fatty AcidsThere are no recommendations for the

amount of fish that is safe for children.

FDA & EPA suggest to follow above

recommendations, but serve smaller

portions sizes.

Page 53: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Omega-3 Fatty AcidsSupplements EPA + DHACod liver oil (liquid) 1,035 mg / teaspoon

Coromega™ (original) 580 mg / packet

*Arctic cod liver oil 207 mg / soft gel

*DHA Junior 52 mg / soft gel

*Nordic Omega-3 Gummies 68 mg / gummy

*Nordic Naturals® products

Common Fortified Foods:

Omega-3 enriched eggs

Milk, Orange Juice, Yogurt, Smart Balance Spread

Page 54: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Additional SupplementsImmune System“Many medical professionals in the autism community believeautistic children are prone to immune system dysfunction.”

Studies indicate that autistic children exhibit atypicalimmune function: Abnormalities in T cells and T cell subsets Depressed responses to T cell mitogens Decreased natural killer cell function Lower percentage of helper-inducer cells Elevation of interleukin-12 Elevation of interferon-gamma Elevation of alpha-interferon levels Deficient form of the C4Bgene Antibodies to myelin basic protein & neuron-axon filament protein

Children with Starving Brains a Medical Treatment Guide for Autism Spectrum DisorderJaquelyn McCandless, MD

Page 55: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Additional SupplementsSupplements to enhance the immune system: Vitamin A Vitamin D Vitamin E Vitamin C Zinc Iron Magnesium Selenium Dimethylglycine (DMG)

Page 56: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Additional Supplements

Supplements to enhance cognitive function:IronZincCholineCoenzyme Q10 (CoQ10)CarnitineGinkgo biloba

Page 57: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Additional Supplements

Detoxification System It is a common belief in the autism community that

autistic children have a dysfunctional detoxification system within their liver.

It is believed that autistic children can not effectively excrete toxins out of their body.

These toxins (mercury, lead, arsenic, pesticides, herbicides, and other chemicals) cross into the brain, cling to brain tissue, and damage the brain.

Autistic children may be more vulnerable to neurological damage caused by exposure to toxins.

Page 58: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Additional SupplementsSupplements to enhance the detoxification system:

GlutathioneVitamin CSeleniumAlpha-Lipoic AcidN-acetylcysteine (NAC)Trimethylglycine (TMG)Milk thistle

Page 59: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

Thank you!!!

Page 60: Three Most Common Questions a WIC Nutritionist is Asked & How to Handle Them Elizabeth Strickland, MS, RD, LD PO Box 3297 Glen Rose, TX 76043 Telephone:

The 10 – Step Nutrition Plan

1. Transition to a healthy diet2. Consume adequate basic nutrients3. Select a multi vitamin/mineral supplement4. Select an omega-3 fatty acid supplement5. Treat child’s feeding problem6. Heal the gastrointestinal tract7. Identify and treat food allergies8. Consider special diets9. Trial response of high dose vitamin B610. Consider additional supplements


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3 lies your nutritionist likes

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Hitachi Single-Chip Microcomputer H8/3297 Series Hardware Manualmueller/rt/rt00/mindstorm/h... · 1998-09-08 · Hitachi Single-Chip Microcomputer H8/3297 Series H8/3297 HD6473297,

Hitachi Single-Chip Microcomputer H8/3297 Series Hardware Manualmueller/rt/rt00/mindstorm/h... · 1998-09-08 · Hitachi Single-Chip Microcomputer H8/3297 Series H8/3297 HD6473297,

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Regim Nutritionist

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Εμπρός 3297

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Samya Ayurvedic Nutritionist Certification

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Nutritionist - CentroNia

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SlimIn7 Nutritionist

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